Narang J, Nowacki AS, Seballos SS, et al. - Researchers investigated if patients that require anti-coagulation can be differentiated from those who do not require anti-coagulation via assessing D-dimer concentration in the absence of imaging. They retrospectively obtained data from 366 hemodynamically stable adult ED patients with suspected pulmonary embolism (PE). Following categorization of patients was performed by largest occluded artery: ‘Require anti-coagulation’ (main, lobar, and segmental PE), ‘Does not require anti-coagulation’ (sub-segmental and No PE), ‘High risk of deterioration’ (main and lobar PE), and ‘Not high risk of deterioration’ (segmental, sub-segmental, and No PE) groups. Findings suggest utility of an age-adjusted D-dimer cut-off of 1,540 ng/mL in differentiating suspected PE patients requiring anti-coagulation from those not necessitating anti-coagulation. Differentiation of those with high risk of clinical deterioration from those not at high risk of deterioration can be done using a cut-off of 2,500. When linked with clinical consequences, these cut-offs can yield an objective method for clinical decision making when imaging is unavailable.